Endocrinology and Metabolism

Michael Doumas

2 Articles

Diabetes, Obesity and Metabolism
Cardiovascular Outcomes with Finerenone According to Glycemic Status at Baseline and Prior Treatment with Newer Antidiabetics among Patients with Type 2 Diabetes Mellitus: Dimitrios Patoulias, Christodoulos Papadopoulos, Asterios Karagiannis, Vassilios Vassilikos, Michael Doumas; Endocrinol Metab. 2022;37(1):170-174. Published online February 9, 2022; DOI: https://doi.org/10.3803/EnM.2021.1296

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Abstract PDF Supplementary Material PubReader ePub

Type 2 diabetes mellitus (T2DM) and cardiovascular disease are closely interconnected. We sought to determine the cardioprotective action of finerenone according to prior treatment with newer antidiabetics and glycemic status. We searched PubMed and Cochrane Library from inception to October 1, 2021 for randomized controlled trials (RCTs) assessing the effect of finerenone on major adverse cardiovascular outcomes in patients with T2DM. We set the primary endpoint as major adverse cardiovascular events (MACE), defined as the composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. We finally included two RCTs in our quantitative synthesis. Compared to placebo, finerenone induced a 23% risk reduction for the composite cardiovascular endpoint, regardless of prior glycemia. We also showed that finerenone provided significant cardiovascular benefit for obese patients with T2DM compared to placebo, although this benefit was diminished for subjects with a body mass index lower than 30 kg/m². Finally, the combination of finerenone with sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists did not produce a significant risk reduction for MACE. We conclude that finerenone provides significant cardiovascular benefits for patients with T2DM, especially for those who are obese, while glycemic status or treatment with newer antidiabetics at baseline does not affect the observed cardioprotective action.

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Finerenone protects against progression of kidney and cardiovascular damage in a model of type 1 diabetes through modulation of proinflammatory and osteogenic factors
M. Sanz-Gómez, F.J. Manzano-Lista, E. Vega-Martín, D. González-Moreno, M. Alcalá, M. Gil-Ortega, B. Somoza, C. Pizzamiglio, L.M. Ruilope, I. Aránguez, P. Kolkhof, R. Kreutz, M.S. Fernández-Alfonso
Biomedicine & Pharmacotherapy.2023; 168: 115661. CrossRef
Research Progress in Finerenone in Cardiovascular Diseases
Sun Xue, Dong Yanghong, Gu Jiaxin, Liu Wenxiu, Liu Yue
Cardiovascular Innovations and Applications.2023;[Epub] CrossRef

Diabetes, Obesity and Metabolism
Dipeptidyl Peptidase-4 Inhibitors and COVID-19-Related Deaths among Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Observational Studies: Dimitrios Patoulias, Michael Doumas; Endocrinol Metab. 2021;36(4):904-908. Published online July 27, 2021; DOI: https://doi.org/10.3803/EnM.2021.1048

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226 Download
19 Web of Science
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Abstract PDF Supplementary Material PubReader ePub

The coronavirus disease 2019 (COVID-19) pandemic remains an unbeaten enemy. Unfortunately, no targeted treatment option is available. Patients with type 2 diabetes mellitus (T2DM) have increased odds for severe or fatal disease, as demonstrated in recent observational studies. There is an ongoing discussion regarding the impact of different antidiabetic drug classes on outcomes of interest among affected subjects. Dipeptidyl peptidase-4 (DPP-4) inhibitors have been placed at the epicenter, since the DPP-4 enzyme seems to be implicated in the disease pathogenesis. Herein we present an updated meta-analysis of observational studies addressing the risk of COVID-19 death among patients with T2DM on prior DPP-4 inhibitor treatment. We pooled data from 10 observational studies, showing that DPP-4 inhibitors produce a non-significant decrease in the risk for COVID-19-related death. However, when administered in the inpatient setting, DPP-4 inhibitors decrease the risk for COVID-19-related death by 50%. Ongoing randomized controlled trials will shed further light.

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